Experience using cryotherapy for treatment of cervical precancerous lesions in low‐resource settings

Abstract

Cervical cancer can be successfully prevented if timely identification of precancerous lesions is followed by effective treatment. In many developing countries, treatment of precancer is neglected because therapeutic services are unavailable, inaccessible, inappropriate, or inadequately linked to screening services. One of the main focuses of the Alliance for Cervical Cancer Prevention (ACCP) has been to ensure that safe and effective methods of treatment for precancer are both available and accessible to women who need them. Cryotherapy, in use for the past 40 years, is a relatively simple, safe, effective, acceptable, and appropriate outpatient procedure for the treatment of precancer. ACCP studies conducted in more than a dozen developing countries show that cryotherapy for precancer can be performed safely and effectively as an outpatient procedure at all levels of health facilities by trained and competent midlevel providers, thus increasing availability and accessibility to precancer treatment services.

Assessing the Environment for Introduction of Human Papillomavirus Vaccine in India~!2009-10-20~!2010-02-02~!2010-04-06~!

“…Of over 100 HPV genotypes, HPV 16 and HPV 18 are associated with some 70 percent of cervical cancer cases, both globally and in Asia, including India [4,5]. New screening and treatment approaches have been demonstrated to be effective [6][7][8][9], but making these approaches widely available remains a challenge. Effective HPV vaccine programs, along with continued strengthening of simple, evidence-based *Address correspondence to this author at the HPV Vaccines: Evidence for Impact project, PATH, A-9 Qutab Institutional Area, New Delhi, India; Tel: 91 11 2653 0080-88; Fax: 91 11 2653 0089; E-mail: mjacob@path.org # Dr. Martha Jacob and Dr. Nita Mawar contributed equally to the Formative Study.…”

Colposcopy audit for improving quality of service in areas with a high incidence of cervical cancer

“…Interestingly, although local destruction (ablative treatment) is generally recognized as one of the treatment choices for CIN [14][15][16][17], it was rarely performed in the study institute because: (1) the majority of women with CIN in the study setting had unsatisfactory colposcopic examination, which contraindicates ablative treatment; and (2) owing to the low sensitivity of colposcopy, occult invasive lesions could not be ruled out even after satisfactory examination [12]. Excision could reduce the possibility of some invasive lesions going unnoticed, because the cervical specimens would be examined histologically.…”

Human Papillomavirus

“…Bunlar; kanser açısından düşük riskli HPV'ler (6,11,40,42,43,44,54, 55 ve 62), olası yüksek riskli HPV'ler (26,53 ve 66) ve yüksek riskli HPV'ler (16 başta olmak üzere 18,31,33,35,39,45,51, 56, 58, 59, 68, 73 ve 82) olarak gruplandırılmaktadırlar 6,7 .…”

“…Özellikle risk altındaki hastalarda yapılan taramalar sonucunda büyük oranda serviks kanseri önlenebilir hale gelmektedir 43 . Buna karşın, HPV ile enfekte olan kişilerin %90'ında yaklaşık viral klirensin olduğu bilinmektedir.…”